Cognitive Impairment in Patients with Coronary Artery Disease; Comparison of Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE)

Background & Objective:  Mild cognitive impairment (MCI) is a transient state between normal condition and dementia. Available data indicates that coronary artery diseases (CAD) may increase the risk of MCI. Hence, the early detection of MCI can prevent the progression of cognitive decline.
Materials & Methods:  A sample of 65 subjects with degrees of CAD was enrolled to the study. For cognitive assessment, Mini Mental State Examination and Montreal Cognitive Assessment were used. Sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of MoCA were assessed in the cut-off points of 26 and 25. The SPSS 22 was used for data analysis. The statistical significance was set at P-value<0.05.
Results:  The prevalence of cognitive impairment was calculated 41.5% and between 47.7% and 60% by MMSE and MoCA, respectively. At the cut-off point of 25 for MoCA test, the sensitivity and specificity were 92.6% and 84.2%, and PPV and NPV were 80.6% and 94.1%, respectively, and the efficacy of MoCA test for the detection of MCI was 87.69%. At the cut-off point of 26 for MoCA test, the sensitivity and specificity were 96.3% and 65.8%, and PPV and NPV were 66.7% and 96.2%, respectively, and the efficacy of MoCA test was 78.46%.
Conclusion:  The prevalence of MCI in patients with CAD was higher than what was previously reported. The MoCA was more sensitive for recognizing the MCI in these patients. We suggested the cut-off point of 25 for the higher accuracy of the MoCA in detecting MCI in CAD patients.